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Urinary Incontinence

  • URINARY INCONTINENCE in Elderly (5 Major Types)
    • Urge (Detrusor Instability) : Bladder Training, Pelvic Muscle Rehabilitation, Fluid Management, Anti-Cholinergics, TCA
    • Stress
      • In Young Patient (When Bladder is Full, and Normal Post Void Residual Volume): Due to Urethral Hypermobility; Pelvic Muscle Rehab, and Bladder Training, Surgery may be the first line of treatment
      • In Old Patient (Even on Empty bladder, and Normal Post Void Residual Volume): Intrinsic Sphincter deficiency ; Pelvic Muscle Rehab and Bladder Training)
      • Treatment: 
        • Non-pharmacological: Risk factors modification; Kegel Exercise
        • Pharmacological: Estrogen Cream; Dulexetine
        • Surgical:
    • Mixed
    • Overflow
    • Functional
    • Tool
      • 3IQ Questionnaire 
    • Treatment (Divide into 3 categories)
      • Non-pharmacological
      • Pharmacological
      • Surgical
Ref:
ACP PIER
Urinary incontinence in women BMJ 2014
Idiopathic Urgency Urinary Incontinence NEJM 2009
Urinary Stress Incontinence in Women NEJM 2008
  • OVERACTIVE BLADDER SYNDROME: Frequncy, Nocturia with or without Urge Incontinence; in the absence of UTI or obvious lesion
    • Dry: without Urge Incontinence
    • Wet: with Urge Incontinence
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